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Utah rates for HCPCS J9050

Injection, carmustine, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $269.15 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $234.42 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $338.84 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $234.42 / $239.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $239.88 / $323.59
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,445.44 / $3,162.28
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $257.04 / $338.84
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $251.19 / $3,801.89
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $239.88 / $354.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $234.42 / $234.42